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Low Thyroid May be Causing Your Depression

Re-printed with thanks to Mary Shomon, excellent thyroid patient advocate.


MARY SHOMON:
 A new study is showing that a rapidly growing number of patients are being prescribed antidepressant medication without a psychiatric diagnosis.  Do you suspect that some of these people are being given antidepressants, instead of the range of thyroid tests needed to properly diagnose hypothyroidism?

Dr.SHAMES:
Absolutely.  Mary, it is more than a suspicion. I know that a great many people with common every day mental symptoms of physical illness, such as low thyroid, are being given antidepressants instead of thyroid tests.  Frequently, they are being given antidepressants without any tests at all  -  not the TSH for thyroid imbalance, not even a simple blood count for anemia, another very common cause of low energy and low mood.

MARY SHOMON:
But, how do you know this for sure?

Dr. SHAMES:
Because of my published thyroid books and a telephone coaching practice, I have had the special opportunity of talking to thyroid patients all over the country.  I can report to you that in every part of the nation, many previously depressed people given antidepressants got better only after their underlying thyroid problem was finally diagnosed and properly treated.

MARY SHOMON:
What is going on here? Is all this an example of massive mis-diagnosis?

DR. SHAMES:  
Yes! This is a tragic mis-application of modern medicine. People with an easily-treated physical thyroid illness, who take antidepressants to feel better mentally, can end up feeling worse. Antidepressants have loads of unpleasant side effects.   Moreover, this improper treatment does not fix the thyroid imbalance and costs patients and their healthcare system tremendous amounts of wasted money.  Meanwhile, the now neglected-for-years physical thyroid illness can under the surface become much more severe.

MARY SHOMON:
Don’t the doctors know this?

Dr. SHAMES:
Everyone knows this.  Treating just the ‘symptom’ of an illness, and not treating the actual underlying cause, is woefully inefficient.  Much of the time, depression’ is a ‘symptom’ of a physical illness like thyroid imbalance, and not a true ‘diagnosis’ in and of itself.  The antidepressant medicine may sometimes offer tentative relief, but in many instances of depression it does not address the root cause of the condition.


MARY SHOMON:
Why would doctors tend to hand out a prescription for an antidepressant for symptoms like fatigue, aches, brain fog, and headaches, rather than run thyroid tests?

A:Dr. SHAMES:
Beats me. Several good controlled studies have indicated that endocrine disorders in general, and thyroid imbalances in particular, are the most frequent medical conditions causing mental symptoms.
Depression is the most common psychiatric condition in the general population. It also happens to be the most common mental symptom of widespread thyroid disease.  Thyroid hormone can help depressed patients stabilize their brain chemistry, especially when antidepressants are not properly effective.

MARY SHOMON:
But what’s the reason prescribers so often ignore all this?

Dr. SHAMES:
I believe that it is most often related to time and money. In a clinic setting, it is much quicker to simply write a prescription for an antidepressant medicine, than it would be to question the patient further about their health history, their family history, or to order thyroid blood tests and wait to see the results.  Also, a simple over-rated TSH test alone is often “normal” in depressed people with mild hypothyroidism.

MARY SHOMON:
How can patients with these kinds of symptoms be taken seriously, rather than sent off with an antidepressant prescription?

Dr. SHAMES:
The first thing depressed patients can do to be taken seriously by their doctors is to approach their medical office visit as any other business negotiation.  Have a written list of the questions you want answered and a list of the testing panel you would like to have ordered.   To check properly for thyroid imbalance, insist on a Free T4, Free T3, TSH, and TPO Antibody.  Tell the doctor you want this more complete panel because of the severity of your thyroid-like symptoms, and because of your family history with thyroid or diabetes or any rheumatoid/autoimmune illnesses, like migraine, colitis, lupus, MS, etc.  

MARY SHOMON:
In your opinion, which is safer -- thyroid medication, or antidepressant medication?

Dr. SHAMES:
Oh that’s easy. Thyroid medicines are much safer than antidepressants. The antidepressants have a wide range of both minor and serious side effects.  The minor ones are just extremely annoying, but the serious ones can be exceedingly dangerous. For instance, there is increased risk of suicide in young men and an increased risk of stroke in older women.

Thyroid treatment on the other hand, is extremely safe.  It is hardly ever involved in these kinds of serious side effects.  In standard doses, thyroid medicines are generally inexpensive, effective, and able to be safely taken for long periods of time
 

MARY SHOMON:
Any final thoughts about the new study, and where can people get further information about this important topic?

Dr. Shames:
This study reveals an unfortunate national trend that needs to be reversed. I recommend making a copy of the citation or abstract, and bringing it with you on your medical visits to show your practitioner.  Regarding further information, this is why we wrote the Thyroid Mind Power book and did the ThyroidMindPower website.  Both the consumers and the providers of medical care need more awareness of this important thyroid connection to mental health.
 

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.